Health IT interoperability in action
Healthcare product manager Lyle McMillin explains how Sophia’s chest CT images are stored and accessed by the oncologist using Hyland solutions.
The HIMSS Interoperability Showcase has become one of the most popular exhibits at the annual conference, and for good reason. The venue is packed with demonstration areas, a large educational theater, a product marketplace and more.
The demonstration areas are particularly compelling. In these locations, six to eight technology vendors collaborate to show how their solutions can be integrated and applied to specific use cases to enhance clinical workflows and patient care. There are several use case demonstrations to take in at HIMSS19, and each lasts between 20 and 30 minutes. The use cases include mother and infant mortality prevention, opioid crisis management, chronic pain management and more.
I attended a use case entitled Enabling Cancer Moonshot. In this session, eight technology vendors (Allscripts, B. Braun Medical, CDC, Epic, Hyland Healthcare, PRA Health Sciences, Spok, and Stanley Healthcare) delivered a live demonstration of how their technology solutions work together to enhance care delivery to a fictional 40-year-old cancer patient named Sophia.
Patient info that travels from initial encounter to referral
Sophia’s journey begins at her dermatologist’s office where she is diagnosed with a 2-millimeter malignant melanoma on her upper back. Her basic encounter information and this initial diagnosis is entered into the Allscripts Sunrise clinical system. This system also creates a cancer event report which is sent to the CDC National Cancer Registry.
The dermatologist then refers Sophia to an oncologist and a Continuity of Care Document (CCD) is created in Sunrise that is sent to the oncologist’s Epic EHR. The oncologist reviews the CCD and orders some additional tests for Sophia which include a biomarker test, some pathology tests and a chest CT to determine if the cancer has spread to her lungs. After the tests are performed, results are sent back to Epic for review.
In particular, a URL is provided that links to images of the chest CT stored in an Acuo VNA by Hyland Healthcare. Upon clicking the URL, Hyland Healthcare’s universal viewer, NilRead launches within Epic where the oncologist can view and annotate the images.
The imaging and pathology results confirm that Sophia has Stage 4 melanoma and this updated information is sent to the CDC Cancer Registry. Meanwhile, the oncologist determines that based on Sophia’s diagnosis and demographic information, she’s an ideal candidate for a clinical trial of a new cancer drug.
Streamlined treatment plans and care delivery
The oncologist accesses a clinical trial application form from PRA Health Sciences and, using the data stored in Epic, prepopulates the form, which is sent back to PRA for assessment. Sophia is approved for the clinical trial and the approval notification is routed to Epic where the oncologist can now outline her treatment that will include administration of the experimental new drug.
When Sophia checks into the hospital to receive her first round of treatment, her patient information and treatment plan are sent to Stanley Healthcare’s real-time location tracking (RTLS) system. Sophia is issued an RTLS tag upon arrival that will track her movement throughout the facility. This tag helps to streamline patient flow and ensure Sophia’s specific wait-time thresholds are met. The Stanley RTLS system also tracks the B. Braun smart infusion pumps that will deliver the experimental new cancer drug.
Treatment information from Epic is routed to these pumps to ensure the proper drug and dose are administered. Dosage rates and tolerance information are also sent from the pump back to Epic to be included as part of the permanent patient record.
If any abnormal event (e.g. adverse reaction, defect with the pump, etc.) occurs, an alarm is triggered by Spok’s emergency notification system. The alert not only registers on the pump itself, but a pop-up screen is displayed within Epic as well to ensure the attending nurse or other clinician is properly notified and takes the appropriate action.
After the drug is successfully administered, it’s time to send Sophia home. A new CCD is generated in Epic and sent to her dermatologist’s Sunrise system to ensure ongoing care. Throughout this whole process, multiple reports are sent to the CDC Cancer Registry in real-time using nationally and internationally accepted standards such as HL7. The information received from these multiple sources is then consolidated into one longitudinal record by the CDC. This record is then anonymized and made available on the Cancer Registry’s public website.
The power of interoperability
The health IT interoperability demonstrated by this use case paints a powerful picture of how integrated technology can transform clinical workflows, patient care and public health. It truly can make healthcare better and have a remarkable impact on patients like Sophia.
If you’re in Orlando for HIMSS19, today is your last chance to check out this and other use case demonstrations. Stop by the Interoperability Showcase, booth 9100, to see them for yourself. If your schedule won’t allow a visit to the Interoperability Showcase or you didn’t make the trip to HIMSS, I invite you to learn more about our Acuo VNA and NilRead solutions that played a key role in Sophia’s journey.
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